Indian study by two Delhi hospitals finds music quietens stress, cuts drug use in surgery

A study carried out by two Delhi hospitals claims that music can make surgery and recovery easier for a patient. A new peer-reviewed study from Delhi's Maulana Azad Medical College and Lok Nayak Hospital, published in the journal Music and Medicine, offers evidence of how playing music during general anaesthesia reduces drug requirements to some extent and helps the patient with recovery. According to the researchers, lower doses of anaesthetic drugs, such as propofol and opioid painkillers, help patients regain consciousness more quickly and clearly. On the other hand, those given higher doses of the same drugs and no music took more time to recover. The study focused on patients undergoing laparoscopic cholecystectomy, the keyhole operation to remove the gallbladder. Researchers tried to understand whether music could reduce how much of propofol and fentanyl patients required.

It started off as a trial with the right patients and grew to an 11-month trial of 56 adults, aged roughly 20 to 45. They were randomly assigned to two groups, all of whom were given a drug that prevents nausea and vomiting, a sedative, fentanyl, propofol and a muscle relaxant. They all wore noise-cancelling headphones, but only one group heard music of their choice - soft flute or piano. "The unconscious mind still has areas that remain active. Even if the music isn't explicitly recalled, implicit awareness can lead to beneficial effects," Dr Farah Husain, senior specialist in anaesthesia and certified music therapist for the study, said.

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They noted that patients who had music on during the surgery required lower doses of propofol and fentanyl. Their recoveries were smoother, and they had "lower cortisol or stress-hormone levels and a much better control of blood pressure during the surgery." Dr Husain said, “We're only beginning to explore how the unconscious mind responds to non-pharmacological interventions like music. It's a way of humanising the operating room.”

Fewer drugs can help with recovery time

Dr Husain says it is important that patients "wake up clear-headed, alert and oriented, and ideally pain-free." Typically, patients are given a mix of five or six drugs to keep the patient asleep, block pain, not remember the surgery and relax the muscles. In gall bladder surgeries, regional "blocks", or ultrasound-guided injections, are also given to numb nerves in the abdominal wall. But the body reacts to anaesthesia, with heart rate and blood pressure spiking. Dr Husain states that this stress response can increase recovery time and worsen inflammation.

The process of intubation makes it worse, wherein a breathing tube is inserted into the windpipe. "The laryngoscopy and intubation are considered the most stressful response during general anaesthesia," Dr Sonia Wadhawan, director-professor of anaesthesia and intensive care at Maulana Azad Medical College and supervisor of the study, said.